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Diabetic hyperglycemic hyperosmolar syndrome - Symptom

Alternative Names

Hyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK)

Symptoms:

Coma
Confusion
Convulsions
Increased thirst
Increased urination (at the beginning of the syndrome)
Lethargy
Nausea
Weakness

Symptoms may get worse over a period of days or weeks.

Other symptoms that may occur with this disease:

Dysfunctional movement
Loss of feeling or function of muscles
Speech impairment

Signs and tests:

Signs may include:

Extreme dehydration
High temperature -- higher than 38 degrees Centigrade (100.4 degrees Fahrenheit)
Increased heart rate
Low systolic blood pressure

Test results include:

High serum osmolarity (concentration)
Higher than normal BUN and creatinine
Higher than normal serum sodium
Mild ketone buildup (ketosis)
Very high blood glucose

Evaluation for possible causes may include:

Food and insulin release

Reviewed last on: 10/6/2008
Deborah Wexler, MD, Assistant Professor of Medicine, Harvard Medical School, Endocrinologist, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29:2739-2748.

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